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George Washington, Smallpox, and the American Revolution

In honor of Presidents' Day, I thought it would be a good idea to talk briefly about the role that smallpox played in the life of our first president, and its important role in the American Revolution. For those who would like to learn about this in greater detail, I would highly recommend the book, Pox Americana: The Great Smallpox Epidemic of 1775-82, written by Elizabeth A. Fenn.
In 1751, when George Washington was 19 years old, he and his brother Lawrence traveled to Barbados, a trip intended to help Lawrence's persistent cough due to tuberculosis. According to Fenn:

On November 3, the day after landing, the two brothers begrudgingly accepted an invitation to dine at the home of Gedney Clarke, a prominent merchant, planter, and slave trader with family ties to the Washingtons. "We went, myself with some reluctance, as the smallpox was in his family," George wrote in his diary. His misgivings were justified. On November 17, when the incubation period had passed, the infection hit hard. "Was strongly attacked with the small Pox," Washington wrote. Thereafter, his journal entries stop. Not until December 12, when he was well enough to go out again, did George Washington return to his diary.

Smallpox did not exist in the Americas until it was brought from Europe, where it was endemic. Settlement of the east coast of North America in 1633 in Plymouth, Massachusetts was accompanied by devastating outbreaks of smallpox among Native American populations and later among the native-born colonists.
At the time of the Revolutionary War, there were several outbreaks of smallpox. Because survival after the disease confers lifelong immunity, this gave a decided advantage to the British, many of who had been exposed to the disease earlier in life. There were even reports that the British were practicing what we would now term biological warfare, by deliberately spreading the disease within Boston and by sending infected people out of the city to spread the epidemic in the American lines.
There were only two ways of dealing with smallpox at the time- isolation or inoculation. Isolation meant preventing susceptible people from coming in contact with the disease, usually by quarantine for affected individuals. Inoculation or variolation, as it was called, required taking a bit of matter from one of the pustules of a smallpox victim and introducing it under the skin of someone who had never had the disease. The resulting case of smallpox was much lighter and greatly decreased the chances of death and scarring. The process was not altogether benign -- unless isolated, those who had received inoculation would be contagious to others, and some who were inoculated actually died of the disease they were trying to avoid.
George Washington, Commander-in-Chief of the Continental Army, was initially hesitant to have his Revolutionary War troops inoculated during a smallpox outbreak, writing, “should We inoculate generally, the Enemy, knowing it, will certainly take Advantage of our Situation.” However, by 1777, faced with mounting smallpox epidemics, battle delays caused by illness among the troops, and fear among potential fighters of getting smallpox if enlisting, Washington devised an elaborate plan to deal with smallpox. Washington ordered mandatory inoculation of all recruits who had not had the disease.

The inoculation campaign had to be conducted with great secrecy. Though it would protect soldiers in the long run and decrease fear of enlistment, it would also incapacitate large numbers for weeks at a time, rendering the Continentals vulnerable to assault. Ultimately, however, it became clear that the spread of smallpox through the ranks presented a graver threat to the army -- and would kill more individuals -- than the Redcoats. Recruits were quarantined in camps and inoculated before being sent out to fight.
- Garance Franke-Ruta

Medical historians credit this move by Washington as a pivotal one.
Smallpox threatened to kill more soldiers than the British, and it was through Washington's efforts that the Continental Army was able to turn this situation around and fight at full strength.

For information about the basics of smallpox, click here to go the the celebritydiagnosis. com story on the topic.

Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.

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